Featured Research

from universities, journals, and other organizations

Low-income Families With Sick Children Often Enrolled In High-deductible Health Care Plans

Date:
March 30, 2009
Source:
Children's Hospital Boston
Summary:
High-deductible health plans are increasingly used by healthy people who are unlikely to incur high medical expenses. But they also end up enrolling many low-income, vulnerable families, finds a new study.

High-deductible health plans are increasingly used by healthy people who are unlikely to incur high medical expenses. But they also end up enrolling many low-income, vulnerable families, finds a study of Massachusetts families from Children's Hospital Boston and Harvard Medical School's Department of Ambulatory Care and Prevention (DACP). The study appears in the April issue of the journal Pediatrics.

The researchers, led by Alison Galbraith, MD, MPH, and Tracy Lieu, MD, MPH, both of Children's and the DACP, used enrollment and claims data from Harvard Pilgrim Health Care, a large New England health plan. They identified 839 families with children who initially had traditional health maintenance organization plans through Harvard Pilgrim, but whose employers later switched them to a high-deductible health plan when Harvard Pilgrim began offering it. They compared this group with 5,133 families whose employers stayed with the traditional plan, to see what kinds of families were most likely to be switched to high-deductible plans.

Overall, about a third of those who were switched to high-deductible plans had a child with a chronic condition, 13 percent lived in neighborhoods with high poverty, 36 percent had an above-average burden of illness, 19 percent incurred large health-care costs at baseline (more than $7,000 a year, including out-of-pocket costs).

"The usual assumption is that high-deductible plans attract healthy and wealthy people, based on studies of people who chose those plans themselves," says Galbraith. "Our population only had one plan offered to them – and we found that many of those who were switched to high-deductible plans had children with chronic conditions. There wasn't a difference in the amount of chronic illness between the high-deductible and traditional families, but it was striking that there wasn't less illness in the high-deductible group. We need to be aware of this as these plans become more popular."

When the same data were analyzed by size of employer, an interesting split emerged:

  • Among the families with large employers, those living in high-poverty neighborhoods were 1.78 times more likely than families in higher-income areas to be switched to a high-deductible plan, after adjustment for other factors (including level of education, known chronic conditions, overall health burden and health costs incurred).
  • Families with small employers were *less* likely to be switched to high-deductible plans if they had more children, an above-average burden of illness and higher health-care expenditures at baseline. Those who *were* switched tended to be healthier and have fewer children.

"Our data show that families with children in high-deductible plans may comprise two distinct groups, one with higher-risk characteristics and one with lower-risk characteristics compared to traditional plans," says Galbraith. "This makes it important to monitor the effects of enrollment in high-deductible plans on children's use of needed care, especially for vulnerable populations that are enrolled."

As high-deductible health plans have become more popular, with 10 percent of employers offering a plan with a high deductible and 14.8 million adults enrolled in 2007(1,2), they are also spreading to families with children. There is growing concern among pediatricians that families facing high out-of-pocket costs may be failing to obtain recommended care.

A national survey published in 2007(2) showed that about half of the people enrolled in high-deductible plans did not have a choice of plans.

The current study was funded by the Harvard Pilgrim Health Care Foundation, the Charles H. Hood Foundation, and the National Institute of Child Health and Human Development.

References

(1)The Kaiser Family Foundation and Health Research and Educational Trust. Employer Health Benefits 2007 Annual Survey.

(2) Fronstin P, Collins SR. Findings From the 2007 EBRI/Commonwealth Fund Consumerism in Health Survey.



Story Source:

The above story is based on materials provided by Children's Hospital Boston. Note: Materials may be edited for content and length.


Cite This Page:

Children's Hospital Boston. "Low-income Families With Sick Children Often Enrolled In High-deductible Health Care Plans." ScienceDaily. ScienceDaily, 30 March 2009. <www.sciencedaily.com/releases/2009/03/090330091609.htm>.
Children's Hospital Boston. (2009, March 30). Low-income Families With Sick Children Often Enrolled In High-deductible Health Care Plans. ScienceDaily. Retrieved July 22, 2014 from www.sciencedaily.com/releases/2009/03/090330091609.htm
Children's Hospital Boston. "Low-income Families With Sick Children Often Enrolled In High-deductible Health Care Plans." ScienceDaily. www.sciencedaily.com/releases/2009/03/090330091609.htm (accessed July 22, 2014).

Share This




More Health & Medicine News

Tuesday, July 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

TheStreet (July 21, 2014) New research shows Gilead Science's drug Sovaldi helps in curing hepatitis C in those who suffer from HIV. In a medical study, the combination of Gilead's Hep C drug with anti-viral drug Ribavirin cured 76% of HIV-positive patients suffering from the most common hepatitis C strain. Hepatitis C and related complications have been a top cause of death in HIV-positive patients. Typical medication used to treat the disease, including interferon proteins, tended to react badly with HIV drugs. However, Sovaldi's %1,000-a-pill price tag could limit the number of patients able to access the treatment. TheStreet's Keris Lahiff reports from New York. Video provided by TheStreet
Powered by NewsLook.com
$23.6 Billion Awarded To Widow In Smoking Lawsuit

$23.6 Billion Awarded To Widow In Smoking Lawsuit

Newsy (July 20, 2014) Cynthia Robinson claims R.J. Reynolds Tobacco Company hid the health and addiction risks of its products, leading to the death of her husband in 1996. Video provided by Newsy
Powered by NewsLook.com
Tooth Plaque Provides Insight Into Diets Of Ancient People

Tooth Plaque Provides Insight Into Diets Of Ancient People

Newsy (July 19, 2014) Research on plaque from ancient teeth shows that our prehistoric ancestor's had a detailed understanding of plants long before developing agriculture. Video provided by Newsy
Powered by NewsLook.com
Contaminated Water Kills 3 Babies in South African Town

Contaminated Water Kills 3 Babies in South African Town

AFP (July 18, 2014) Contaminated water in South Africa's northwestern town of Bloemhof kills three babies and hospitalises over 500 people. The incident highlights growing fears over water safety in South Africa. Duration: 02:22 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins